Prognosis of patients with heart failure and obstructive sleep apnea treated with continuous positive airway pressure

Chest. 2008 Mar;133(3):690-6. doi: 10.1378/chest.07-1901. Epub 2008 Jan 15.


Background: Therapy with continuous positive airway pressure (CPAP) provides several benefits for patients with heart failure (HF) complicated by obstructive sleep apnea (OSA). However, the effect on the prognosis of such patients remains unknown.

Aims: To determine whether CPAP therapy and compliance affects the prognosis of HF patients with OSA.

Methods: We classified 88 patients with HF and moderate-to-severe OSA into a CPAP-treated group (n = 65) and an untreated group (n = 23), and then those treated with CPAP were further subclassified according to CPAP therapy compliance. The frequency of death and hospitalization was analyzed using multivariate analysis.

Results: During a mean (+/- SD) period of 25.3 +/- 15.3 months, 44.3% of the patients died or were hospitalized. Multivariate analysis showed that the risk for death and hospitalization was increased in the untreated group (hazard ratio [HR], 2.03; 95% confidence interval [CI], 1.07 to 3.68; p = 0.030) and in less compliant CPAP-treated patients (HR, 4.02; 95% CI, 1.33 to 12.2; p = 0.014).

Conclusion: Therapy with CPAP significantly reduced the risk of death and hospitalization among patients with HF and OSA. However, reduced compliance with CPAP therapy was significantly associated with an increased risk of death and hospitalization.

Publication types

  • Comparative Study

MeSH terms

  • Continuous Positive Airway Pressure / methods*
  • Female
  • Follow-Up Studies
  • Heart Failure / complications
  • Heart Failure / epidemiology
  • Heart Failure / therapy*
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Patient Compliance
  • Polysomnography
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / epidemiology
  • Sleep Apnea, Obstructive / therapy*
  • Survival Rate / trends
  • Time Factors